Tarn Derjung M, Heritage John, Paterniti Debora A, Hays Ron D, Kravitz Richard L, Wenger Neil S
Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024-4142, USA.
Commun Med. 2008;5(2):195-208. doi: 10.1558/cam.v5i2.195.
Physician-patient communication about new medications can influence patient medication adherence. Little is known about the detailed content of conversations about new medications, or about how physicians and patients word information when discussing new medications. Yet nuances in communication may influence patient comprehension and affect behaviour. A comprehensive coding framework delineating the intricacies of physician-patient discussions is needed to better understand the range of communication about new prescriptions. This study used analytic induction to analyse 185 audiotaped outpatient encounters, during which 243 new medications were prescribed by family physicians, internists and cardiologists in two healthcare settings. Seventy-six codes were developed to demonstrate the range of physician counselling about information concerning new prescriptions, such as medication name, purpose, directions for use, side effects, acquisition and monitoring. The conversational content represented by the codes can be used to understand the breadth of conversations regarding new medications, identify sources of potential patient misunderstandings when medication instructions are conveyed, and inform recommendations for desired communication content. The coding system also can be used to measure the quality of new medication discussions for linkage to outcomes and can inform interventions to improve communication when prescribing new drugs.
医生与患者就新药进行的沟通会影响患者的用药依从性。对于有关新药的谈话详细内容，或者医生和患者在讨论新药时如何措辞信息，我们了解甚少。然而，沟通中的细微差别可能会影响患者的理解并进而影响其行为。需要一个全面的编码框架来描绘医患讨论的复杂性，以便更好地理解有关新处方的沟通范围。本研究采用分析归纳法分析了185次门诊录音，在此期间，家庭医生、内科医生和心脏病专家在两种医疗环境中开出了243种新药。制定了76个编码，以展示医生就新处方信息进行咨询的范围，如新药名称、用途、使用说明、副作用、获取方式和监测等。这些编码所代表的对话内容可用于理解有关新药谈话的广度，确定传达用药说明时潜在患者误解的来源，并为期望的沟通内容提供建议。该编码系统还可用于衡量新药讨论的质量，以便与结果建立联系，并为开新药时改善沟通的干预措施提供依据。
